At her first prenatal appointment for her first pregnancy, Shana Westlake of Beacon, New York, remembers entering her OB-GYN‘s office full of anxiety.
“They took my blood pressure, and it was through the roof,” Westlake says.
She wondered whether her high blood pressure was cause for alarm. Thankfully, as it turned out, everything was fine.
“The nurse patted me on the arm and said we’d check again at the end of the appointment,” Westlake says. “After an ultrasound to confirm there was a baby in there and listening to the strong heartbeat, they checked my blood pressure again. It had dropped back down to a normal, healthy range.”
Her experience is not unique or uncommon. Navigating pregnancy can be an overwhelming process overall, but that first prenatal appointment can be particularly daunting. You may be a bundle of nerves as you anxiously wait to find out if everything is going well. All the questions you mean to ask about may fly out of your head — or you may be so full of questions you don’t know where to start.
While there are many specific questions you’ll need to ask based on your individual case and test results, there are key questions that you should ask your obstetrician about your pregnancy and treatment plan at that first appointment.
“To ensure a healthy pregnancy, women should ask about physical and emotional changes during pregnancy,” says Dr. Brian Rodriguez-Echevarria, an OB-GYN with UTHealth Houston. In addition, you’ll want to ask about the schedule of appointments, as well as early thoughts on the delivery plan.
Bring this handy list to refer to during your first OB appointment.
[READ: Best Morning Sickness Remedies During Pregnancy]
1. What pregnancy symptoms are normal, and which aren’t?
It’s crucial to ask your doctor which symptoms are just normal discomforts due to physiological changes in the body, which ones require a doctor’s visit within a few days and which could indicate serious complications and warrant immediate care at an ER or urgent care center, says Dr. Aparna Sridhar, an OB-GYN at UCLA Health and associate clinical professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA.
Ask if there is a nurse’s line or another number to reach out if you’re experiencing unusual symptoms, and let your doctor know of any unexpected changes, Rodriguez-Echevarria says. If you’re not sure what’s going on, it’s always best to err on the side of caution and call.
Normal pregnancy symptoms, like morning sickness, include:
— Nausea
— Vomiting
— Fatigue
Concerning symptoms include:
— Vaginal bleeding
— Urinary tract infection symptoms, like burning when urinating
— Leaking of fluid, which might indicate water breaking early
— Unexplained fever, which could indicate an infection
— Chest pain or shortness of breath
— Leg swelling with redness and warmth, especially on one side, which could indicate a blood clot
— Decreased fetal movement
— Painful contractions or intense stomach pain
— Severe headache or vision problems, which might indicate preeclampsia
[READ: Checklist for Choosing a Maternity Hospital.]
2. What activities can I do during pregnancy, and which should I avoid?
Most activities can be continued during pregnancy, says Dr. Myra J. Wick, a specialist in the Department of Obstetrics and Gynecology and the Department of Medical Genetics at Mayo Clinic, and author of “Mayo Clinic Guide to a Healthy Pregnancy.”
However, people with pregnancy complications — such as placental abnormalities — may need to modify their activities.
Ask questions about what you can or can’t do, such as:
Exercise
In general, exercise during pregnancy is encouraged, but pregnant people should ask about activities that may increase the risk for falls or injury, such as contact sports, skiing, rollerblading and rock climbing, as any significant fall or trauma to the abdomen could result in placental abruption or significant injury.
Only your provider can assess your personal and family medical history to offer individualized guidance on exercise tailored to your situation.
“Relying on the internet for advice is not always ideal, as it cannot provide personalized recommendations based on your unique health circumstances,” Sridhar says.
Hobbies
You should inquire about whether or not your hobbies are safe, especially if they include working with toxic materials, to make sure that there is no risk of exposure to harmful substances.
These activities might include:
— Furniture restoration
— Painting
— Home improvement
— Ceramics
Travel
Travel during pregnancy is generally safe for most women until they get close to their due dates.
“It’s good to discuss the optimal time to travel, usually between 14 and 28 weeks, and if there are any contraindications based on personal health factors,” Sridhar says.
For international travel, ask if your plans include areas where the Zika virus is present, which is primarily spread by mosquitoes and can cause birth defects if a pregnant woman contracts it. Also, make sure your vaccinations are up to date.
“I always recommend they carry a copy of their health records and be aware of symptoms that require immediate medical attention, such as vaginal bleeding or severe abdominal pain,” Sridhar says.
During travel, Sridhar says to:
— Wear loose-fitting clothing
— Take regular breaks to move around to prevent blood clots, also referred to as deep vein thrombosis
Sex
Sex is generally safe during pregnancy, but keep in mind that your comfort level and desire may vary as your baby grows and your body adjusts. Be sure to ask your doctor about safe sexual activities during pregnancy, especially if you have certain conditions, such as vaginal bleeding, cervical incompetence, placenta previa (in which the placenta covers the cervical opening) or a history of miscarriage or preterm labor.
“Open communication with your provider ensures safety and addresses any concerns,” Sridhar says.
[Natural Ways to Induce Labor: What Experts Recommend]
3. What foods and drinks are safe and unsafe?
What you can and can’t eat while pregnant can be a tricky issue.
“Cultural recommendations about what to eat or avoid may not always be supported by scientific evidence,” Sridhar says.
Healthy foods to eat during pregnancy include fresh fruits, vegetables, lean meats and whole grains.
But there are certain foods you should avoid, including:
— Uncooked or undercooked meat or fish, such as sushi
— Cold deli meats
— Unpasteurized dairy products, such as raw milk and cheeses
— Foods containing raw eggs, like dressings and sauces
— High-mercury fish, such as swordfish
Experts recommend avoiding alcohol and limiting your caffeine intake to 200 milligrams per day. If you typically drink a lot of caffeine, talk to your doctor about your consumption and safe alternatives to moderate your intake during pregnancy.
[READ Protein During Pregnancy: How Much?]
4. What medicines and supplements can I take?
It’s essential to discuss with your health care provider which medications you can take during pregnancy.
“A thorough review of any current medications is crucial to ensure they are safe and not harmful to fetal development,” Sridhar says.
The main dietary supplement you should take while pregnant is prenatal vitamins to ensure you and your baby are getting all the necessary nutrients for a healthy pregnancy.
“On most occasions, one daily prenatal vitamin will be the recommended dose, but there might be occasions in which your provider might recommend additional vitamins or supplements,” Rodriguez-Echevarria says.
While most over-the-counter vitamins are safe, including vitamin D, folic acid, iron, calcium, magnesium and fish oil, be sure to ask about any herbal supplements you’re taking. That’s because supplements are not regulated by the Food and Drug Administration and could possibly contain harmful ingredients.
5. How much weight should I gain?
Overall weight gain is an important topic to discuss with your doctor, but this question will have a very individualized answer.
“Weight gain will depend on pre-pregnancy (body mass index),” Wick says.
Although you’ll want to maintain a healthy weight, pregnant women shouldn’t go on a weight loss diet because your body will need all the nutrients it can get for the baby’s development.
6. What can I expect at my appointments?
You’ll want to know what your appointment schedule is going to be like.
“Ask about frequency of visits, and what is done at each visit,” Wick says.
How often you come in might depend on if your pregnancy is low or high risk.
“It’s important to discuss plans for monitoring both uncomplicated pregnancies and those complicated by maternal or neonatal medical conditions,” Sridhar says.
Even if you’re low risk now, it’s always possible complications could develop, requiring more frequent visits and a maternal-fetal medicine doctor, a type of specialized provider within obstetrics.
You’ll also want to ask what tests and procedures are done and when, such as ultrasounds. Several screening tests should happen at specific points in pregnancy, so you’ll want to make sure you know when you’re supposed to schedule them.
Also, you can ask what additional tests, such as genetic testing, may be available to you and when it would be appropriate to have them done.
7. What vaccines should I have during pregnancy?
Another crucial topic is vaccines during pregnancy, including which are recommended and when you should get them.
The vaccines you’d receive during pregnancy are not harmful to you or your baby.
The four main vaccines are:
— RSV
— Tetanus, diphtheria and pertussis (Tdap)
— COVID-19
— Flu
Additional vaccines — such as those for hepatitis A and hepatitis B — may be recommended by your doctor if you are at risk for infection or aren’t up to date on your vaccinations.
8. What will be the plan for delivery?
You might not know exactly what detailed questions to ask about the delivery if this is your first pregnancy, and that’s OK. While it might seem a little early, it’s best to talk about it now.
“Asking those questions early on in pregnancy can help relieve the stress that comes with the unknown at the time of delivery,” Rodriguez-Echevarria says.
Plus, having a discussion now about delivery expectations will help you have a positive experience later. You’ll want to make sure your doctor’s views line up with your own.
The major questions to ask are where you’ll be delivering – and how you’ll know what doctor will be delivering your baby. Often, you’ll end up with whatever doctor is on call when you give birth, which can be a little unnerving.
“The provider who follows you in the clinic is not expected to be present at delivery,” Wick says.
In preparation for the big day, ask to see if there are prenatal classes and educational materials available, as this will help you develop a list of your preferred birth plan during your pregnancy.
“You can mention during your first visit that this is something important to you,” Sridhar says.
Birth plan topics you might want to ask about include:
— Pain management options, including medicated and non-medicated
— The doctor’s C-section rate and in what cases one would be performed
— Elective inductions, including when this would happen and what’s involved
— Delayed cord clamping after birth
— Skin-to-skin and/or breastfeeding immediately after birth (including after a C-section)
— The number of support people allowed in the delivery room, including doulas
If this isn’t your first baby, you should still ask the questions, as protocols and personal preferences might have changed.
“It’s valuable to discuss prior experiences, identify aspects that were not ideal and explore how things can be different or improved this time around,” Sridhar says.
9. How will any medical issues I have affect my pregnancy?
If you have any minor or major medical conditions, let your doctor know and ask how they may affect your pregnancy or how pregnancy might impact those conditions.
“Additionally, it is important to talk about emotional well-being, including any current or past mental health issues, allergies, previous surgeries and other relevant medical history,” Sridhar says.
10. What else do I need to know until my next appointment?
You may not be able to get through all of your questions during your first OB-GYN appointment, and even if you do, there’s going to be more information you’ll need to know. It can feel like drinking from a firehose, but you’ll have plenty more visits to follow-up and ask more questions.
Before you leave your doctor’s office, be sure to ask what else you need to know until your next visit.
Your doctor should take the time to listen and respond, particularly if this is the first time you’ve been through this.
“Consulting your provider ensures you receive accurate, individualized feedback to support a healthy pregnancy,” Sridhar says.
It can also help to have a support person with you at the first appointment — such as your partner, family member or friend — to write down what the doctor says, help steady your nerves and make sure you get your questions answered.
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10 Questions to Ask Your OB at Your First Appointment originally appeared on usnews.com